Soleus Activity Research Articles

The Effect of Ankle Foot Orthosis' Design and Degree of Dorsiflexion on Achilles Tendon Biomechanics-Tendon Displacement, Lower Leg Muscle Activation, and Plantar Pressure During Walking.

Background: Following an Achilles tendon rupture, ankle foot orthoses (AFO) of different designs are used to protect the healing tendon. They are generally designed to protect against re-rupture by preventing undesired dorsiflexion and to prevent elongation by achieving plantarflexion in the ankle. There is limited knowledge of the biomechanical effects of different AFO designs and ankle angles on the tendon and lower leg muscles.Hypothesis: The hypothesis was that non-uniform displacement in the Achilles tendon, lower leg muscle activity, and plantar pressure distribution would be affected differently in different designs of AFO and by varying the degree of dorsiflexion limitation.Study Design: Controlled laboratory study.Methods: Ultrasound of the Achilles tendon, EMG of the lower leg muscles and plantar pressure distribution were recorded in 16 healthy subjects during walking on a treadmill unbraced and wearing three designs of AFO. Ultrasound speckle tracking was used to estimate motion within the tendon. The tested AFO designs were a rigid AFO and a dorsal brace used together with wedges and an AFO with an adjustable ankle angle restricting dorsiflexion to various degrees.Results: There were no significant differences in non-uniform tendon displacement or muscle activity between the different designs of AFO. For the rigid AFO and the adjustable AFO there was a significant reduction in non-uniform displacement within the tendon and soleus muscle activity as restriction in dorsiflexion increased.Conclusion: The degree of dorsiflexion allowed within an AFO had greater effects on Achilles tendon displacement patterns and muscle activity in the calf than differences in AFO design. AFO settings that allowed ankle dorsiflexion to neutral resulted in displacement patterns in the Achilles tendon and muscle activity in the lower leg which were close to those observed during unbraced walking.

Oral Lactate Administration Additively Enhances Endurance Training-Induced Increase in Cytochrome C Oxidase Activity in Mouse Soleus Muscle.

We tested the hypothesis that oral lactate supplementation increases mitochondrial enzyme activity given the potential role of lactate for inducing mitochondrial biogenesis. In this study, mice were assigned to a saline-ingested sedentary group (S+S; n = 8), a lactate-ingested sedentary group (L+S; n = 9), a saline-ingested training group (S+T; n = 8), and a lactate-ingested training group (L+T; n = 8). Mice in the S+S and S+T groups received saline, whereas mice in the L+S and L+T groups received sodium lactate (equivalent to 5 g/kg of body weight) via oral gavage 5 days a week for 4 weeks. At 30 min after the ingestion, mice in the S+T and L+T groups performed endurance training (treadmill running, 20 m/min, 30 min, 5 days/week). At 30 min after lactate ingestion, the blood lactate level reached peak value (5.8 ± 0.4 mmol/L) in the L+S group. Immediately after the exercise, blood lactate level was significantly higher in the L+T group (9.3 ± 0.9 mmol/L) than in the S+T group (2.7 ± 0.3 mmol/L) (p < 0.01). Following a 4-week training period, a main effect of endurance training was observed in maximal citrate synthase (CS) (p < 0.01; S+T: 117 ± 3% relative to S+S, L+T: 110 ± 3%) and cytochrome c oxidase (COX) activities (p < 0.01; S+T: 126 ± 4%, L+T: 121 ± 4%) in the plantaris muscle. Similarly, there was a main effect of endurance training in maximal CS (p < 0.01; S+T: 105 ± 3%, L+T: 115 ± 2%) and COX activities (p < 0.01; S+T: 113 ± 3%, L+T: 122 ± 3%) in the soleus muscle. In addition, a main effect of oral lactate ingestion was found in maximal COX activity in the soleus (p < 0.05; L+S: 109 ± 3%, L+T: 122 ± 3%) and heart muscles (p < 0.05; L+S: 107 ± 3%, L+T: 107 ± 2.0%), but not in the plantaris muscle. Our results suggest that lactate supplementation may be beneficial for increasing mitochondrial enzyme activity in oxidative phenotype muscle.

Ultrasound imaging links soleus muscle neuromechanics and energetics during human walking with elastic ankle exoskeletons

Unpowered exoskeletons with springs in parallel to human plantar flexor muscle-tendons can reduce the metabolic cost of walking. We used ultrasound imaging to look ‘under the skin’ and measure how exoskeleton stiffness alters soleus muscle contractile dynamics and shapes the user’s metabolic rate during walking. Eleven participants (4F, 7M; age: 27.7 ± 3.3 years) walked on a treadmill at 1.25 m s−1 and 0% grade with elastic ankle exoskeletons (rotational stiffness: 0–250 Nm rad−1) in one training and two testing days. Metabolic savings were maximized (4.2%) at a stiffness of 50 Nm rad−1. As exoskeleton stiffness increased, the soleus muscle operated at longer lengths and improved economy (force/activation) during early stance, but this benefit was offset by faster shortening velocity and poorer economy in late stance. Changes in soleus activation rate correlated with changes in users’ metabolic rate (p = 0.038, R2 = 0.44), highlighting a crucial link between muscle neuromechanics and exoskeleton performance; perhaps informing future ‘muscle-in-the loop’ exoskeleton controllers designed to steer contractile dynamics toward more economical force production.

The effects of fatigue on synergy of selected lower limb muscles during running

The purpose of this study was to investigate the effect of fatigue on selected lower extremity muscles synergy during running using non-negative matrix factorization algorithm method. Sixteen male recreational runners participated in this study. The surface electromyographic activity of rectus femoris (RF), vastus lateralis (VL), vastus medialis (VM), biceps femoris (BF), semitendinosus, gastrocnemius medialis (GM), soleus (SO) and tibialis anterior (TA) were recorded on treadmill at 3.3 m s−1 before and after the fatigue protocol. Synergy pattern and relative muscle weight were calculated by non-negative matrix factorization (NNMF) algorithm method. The results showed that using the VAF method, five muscle synergies were extracted from the emg data during running. After the fatigue, the number of muscular synergies did not show a change, but relative weight of the muscles changed. Fatigue did not have any effect on the structure of muscular synergy, but changed the relative weight of muscles. These changes could be the strategy of the central nervous system to maintain optimal function of the motor system.

Modular footwear that partially offsets downhill or uphill grades minimizes the metabolic cost of human walking.

Walking on different grades becomes challenging on energetic and muscular levels compared to level walking. While it is not possible to eliminate the cost of raising or lowering the centre of mass (COM), it could be possible to minimize the cost of distal joints with shoes that offset downhill or uphill grades. We investigated the effects of shoe outsole geometry in 10 participants walking at 1 m s−1 on downhill, level and uphill grades. Level shoes minimized metabolic rate during level walking (Psecond-order effect < 0.001). However, shoes that entirely offset the (overall) treadmill grade did not minimize the metabolic rate of walking on grades: shoes with a +3° (upward) inclination minimized metabolic rate during downhill walking on a −6° grade, and shoes with a −3° (downward) inclination minimized metabolic rate during uphill walking on a +6° grade (Pinteraction effect = 0.023). Shoe inclination influenced (distal) ankle joint parameters, including soleus muscle activity, ankle moment and work rate, whereas treadmill grade influenced (whole-body) ground reaction force and COM work rate as well as (distal) ankle joint parameters including tibialis anterior and plantarflexor muscle activity, ankle moment and work rate. Similar modular footwear could be used to minimize joint loads or assist with walking on rolling terrain.

Ankle Exoskeleton Assistance Can Improve Over-Ground Walking Economy in Individuals With Cerebral Palsy.

Individuals with neuromuscular impairment from conditions like cerebral palsy face reduced quality of life due to diminishing mobility and independence. Lower-limb exoskeletons have potential to aid mobility, yet few studies have investigated their use during over-ground walking - an exercise that may contribute to our understanding of potential benefit in free-living settings. The goal of this study was to determine the potential for adaptive plantar-flexor assistance from an untethered ankle exoskeleton to improve over-ground walking economy and speed. Six individuals with cerebral palsy completed three consecutive daily over-ground training sessions to acclimate to, and tune, assistance. During a final assessment visit, metabolic cost, walking speed, and soleus electromyography were collected for baseline, unpowered, low, training-tuned, and high assistance conditions. Compared to each participant's baseline condition, we observed a 3.9 ± 1.9% (p = 0.050) increase in walking speed and a 22.0 ± 4.5% (p = 0.002) reduction in soleus activity with training-tuned assistance; metabolic cost of transport was unchanged (p = 0.130). High assistance resulted in an 8.5 ± 4.0% (p = 0.042) reduction in metabolic cost of transport, a 6.3 ± 2.6% (p = 0.029) increase in walking speed, and a 25.0 ± 4.0% (p < 0.001) reduction in soleus activity. Improvement in exoskeleton-assisted walking economy was related to pre-training baseline walking speed ( [Formula: see text], p = 0.001); the slower and more impaired participants improved the most. Energy cost and preferred walking speed remained generally unchanged for the faster and less impaired participants. These findings demonstrate that powered ankle exoskeletons have the potential to improve mobility-related outcomes for some people with cerebral palsy.

Rightward shift of optimal fascicle length with decreasing voluntary activity level in the soleus and lateral gastrocnemius muscles.

Much of our understanding of in vivo skeletal muscle properties is based on studies performed under maximal activation, which is problematic because muscles are rarely activated maximally during movements such as walking. Currently, force-length properties of the human triceps surae at submaximal voluntary muscle activity levels are not characterized. We therefore evaluated plantar flexor torque- and force-ankle angle, and torque- and force-fascicle length properties of the soleus and lateral gastrocnemius muscles during voluntary contractions at three activity levels: 100, 30 and 22% of maximal voluntary contraction. Soleus activity levels were controlled by participants via real-time electromyography feedback and contractions were performed at ankle angles ranging from 10 deg plantar flexion to 35 deg dorsiflexion. Using dynamometry and ultrasound imaging, torque-fascicle length curves of the soleus and lateral gastrocnemius muscles were constructed. The results indicate that small muscle activity reductions shift the torque- and force-angle, and torque- and force-fascicle length curves of these muscles to more dorsiflexed ankle angles and longer fascicle lengths (from 3 to 20% optimal fascicle length, depending on ankle angle). The shift in the torque- and force-fascicle length curves during submaximal voluntary contraction have potential implications for human locomotion (e.g. walking) as the operating range of fascicles shifts to the ascending limb, where muscle force capacity is reduced by at least 15%. These data demonstrate the need to match activity levels during construction of the torque- and force-fascicle length curves to activity levels achieved during movement to better characterize the lengths that muscles operate at relative to their optimum during a specific task.

Impact of seated and standing positions on triceps surae muscle activation in unilateral Achilles tendon rupture.

Heel-rises are commonly used in the rehabilitation of individuals following Achilles tendon rupture, however, the impact of tendon elongation on triceps surae activation in seated versus standing positions has not been investigated. The purpose of this study was to investigate changes in triceps surae activation during seated compared to standing heel-rises in individuals with Achilles tendon rupture and its relationship to tendon elongation. Ten individuals with a history of Achilles tendon rupture were included in this study. Muscle activity using electromyography was examined during a heel-rise task in seated (unilateral) and standing (bilateral) positions. Soleus activity was not significantly different between sitting and standing on both the ruptured and uninjured side. On the ruptured, side there were no differences in medial or lateral gastrocnemius activity between sitting and standing; however, on the uninjured side medial and lateral gastrocnemius activity was lower in sitting compared to standing. The results of this study suggest that neuromuscular changes in triceps surae activation occur following Achilles tendon rupture. The seated heel-rise position can be used to strengthen all muscles of the triceps surae and is useful when the patient is unable to perform a standing heel-rise.

Novel role of Tieg1 in muscle metabolism and mitochondrial oxidative capacities.

Tieg1 is involved in multiple signalling pathways, human diseases, and is highly expressed in muscle where its functions are poorly understood. We have utilized Tieg1 knockout (KO) mice to identify novel and important roles for this transcription factor in regulating muscle ultrastructure, metabolism and mitochondrial functions in the soleus and extensor digitorum longus (EDL) muscles. RNA sequencing, immunoblotting, transmission electron microscopy, MRI, NMR, histochemical and mitochondrial function assays were performed. Loss of Tieg1 expression resulted in altered sarcomere organization and a significant decrease in mitochondrial number. Histochemical analyses demonstrated an absence of succinate dehydrogenase staining and a decrease in cytochrome c oxidase (COX) enzyme activity in KO soleus with similar, but diminished, effects in the EDL. Decreased complex I, COX and citrate synthase (CS) activities were detected in the soleus muscle of KO mice indicating altered mitochondrial function. Complex I activity was also diminished in KO EDL. Significant decreases in CS and respiratory chain complex activities were identified in KO soleus. 1 H-NMR spectra revealed no significant metabolic difference between wild-type and KO muscles. However, 31 P spectra revealed a significant decrease in phosphocreatine and ATPγ. Altered expression of 279 genes, many of which play roles in mitochondrial and muscle function, were identified in KO soleus muscle. Ultimately, all of these changes resulted in an exercise intolerance phenotype in Tieg1 KO mice. Our findings have implicated novel roles for Tieg1 in muscle including regulation of gene expression, metabolic activity and organization of tissue ultrastructure. This muscle phenotype resembles diseases associated with exercise intolerance and myopathies of unknown consequence.

Biomechanical effects of passive hip springs during walking

Passive spring-like structures can store and return energy during cyclic movements and thereby reduce the energetic cost of locomotion. That makes them important components of the human body and wearable assistive devices alike. This study investigates how springs placed anteriorly across the hip joint affect leg joint angles and powers, and leg muscle activities during level walking at 0.5 to 2.1 m/s.We hypothesized that the anterior hip springs (I) load hip extension, (II) support hip flexion and (III) affect ankle muscle activity and dynamics during walking. Effects at the ankle were expected because hip and ankle redistribute segmental power in concert to achieve forward progression.We observed that the participants’ contribution to hip power did not increase during hip extension as the spring stored energy. Simultaneously, the activities of plantarflexor muscles that modulate energy storage in the Achilles tendon were reduced by 28% (gastrocnemius medialis) and 9% (soleus). As the spring returned energy with the onset of hip flexion, the participants’ contribution to hip power was reduced by as much as 23%. Soleus activity before push-off increased by up to 9%.Instead of loading hip extension, anterior hip springs seem to store and return parts of the energy normally exchanged with the Achilles tendon. Thereby, the springs support hip flexion but may reduce elastic energy storage in and hence recoil from the Achilles tendon. This interaction should be considered during the design and simulation of wearable assistive devices as it might – depending on user characteristics – enhance or diminish their overall functionality.

Heuristic-Based Ankle Exoskeleton Control for Co-Adaptive Assistance of Human Locomotion.

Assisting human locomotion with exoskeletons is challenging, largely due to the complexity of the neuromusculoskeletal system, the time-varying dynamics that accompany motor learning, and the uniqueness of every individual's response to device assistance. Assistance strategies designed to keep the human "in-the-loop" can help overcome many of these challenges. The purpose of this study was to develop a human-in-the-loop assistance strategy that uses co-adaptive control to slowly and continuously respond to biomechanical changes thought to encode the user's needs. Online measurements of muscle activity and joint kinematics were used to guide the evolution of an exoskeleton torque pattern based on the following heuristics: 1) muscle activity that acts cooperatively with the exoskeleton indicates the user wants more torque; 2) muscle activity that acts antagonistically to the exoskeleton indicates the user wants less torque; and 3) torque should stop increasing if the user is not adapting. We applied our controller to tethered, bilateral ankle exoskeletons worn by naïve participants as they walked on a treadmill at 1.25 m · s-1 for 30 minutes. The evolved torque profiles reduced the root-mean-square of soleus muscle activity by 35±12% and metabolic rate by 22±8% compared to walking with the exoskeletons while they provided no torque. This was equivalent to a 9±12% reduction in metabolic rate when compared to normal walking. Furthermore, the algorithm was responsive to changes in each user's coordination patterns. These results confirm the effectiveness of the controller and suggest a new approach to exoskeleton assistance aimed at fostering co-adaptation with the user. This technique might particularly benefit individuals with age-related muscle weakness.

Body temperature control in rats by muscle tone during rest or sleep.

To explore the role of tonic motor unit activity in body temperature control. Motor unit activity in soleus and several other skeletal muscles was recorded electromyographically from adult rats placed in a climate chamber on a load sensitive floor, which, together with video monitoring, allowed detection of every successive period of movement and no movement. In the absence of movements during rest or sleep, motor unit activity was exclusively tonic and therefore equivalent to muscle tone as defined here. The amount of tonic activity increased linearly in the soleus as the ambient temperature decreased from 32°C to below 7°C, owing to progressive recruitment and increased firing rate of individual units. Brief movements occurred randomly and frequently during rest or sleep in association with brief facilitation or inhibition of motor neurons that turned tonic motor unit activity on or off, partitioning the tonic activity among the available motor units. Shivering first appeared when a falling ambient temperature reached ≤7°C in several muscles except soleus, which was as active between shivering bursts as during them. Muscle tone and overt shivering are strikingly different phenomena. Tonic motor unit activity in the absence of movements evokes isometric contractions and, therefore, generates heat. Accordingly, when the amount of tonic activity increases with falling ambient temperature, so must heat production. Consequently, graded muscle tone appears as an important and independent mechanism for thermogenesis during rest or sleep at ambient temperatures ranging from <7°C to at least 32°C.

UCHL1 regulates muscle fibers and mTORC1 activity in skeletal muscle

AimsSkeletal muscle wasting is associated with many chronic diseases. Effective prevention and treatment of muscle wasting remain as a challenging task due to incomplete understanding of mechanisms by which muscle mass is maintained and regulated. This study investigated the functional role of Ubiquitin C-terminal hydrolase L1 (UCHL1) in skeletal muscle. Main methodsMice with skeletal muscle specific gene knockout of UCHL1 and C2C12 myoblast cells with UCHL1 knockdown were used. Muscle fiber types and size were measured using tissue or cell staining. The mammalian target of rapamycin complex 1 (mTORC1) and mTORC2 activities were assessed with the phosphorylation of their downstream targets. Key findingsIn mouse skeletal muscle, UCHL1 was primarily expressed in slow twitch muscle fibers. Mice with skeletal muscle specific knockout (skmKO) of UCHL1 exhibited enlarged muscle fiber sizes in slow twitch soleus but not fast twitch extensor digitorum longus (EDL) muscle. Meanwhile, UCHL1 skmKO enhanced mTORC1 activity and reduced mTORC2 activity in soleus but not in EDL. Consistently, in C2C12 cells, UCHL1 knockdown increased the myotube size, enhanced mTORC1 activity, and reduced mTORC2 activities as compared with control cells. UCHL1 knockdown did not change the major proteins of mTOR complex but decreased the protein turnover of PRAS40, an inhibitory factor of mTORC1. SignificanceThese data revealed a novel function of UCHL1 in regulation of mTORC1 activity and skeletal muscle growth in slow twitch skeletal muscle. Given the upregulation of UCHL1 in denervation and spinal muscle atrophy, our finding advances understanding of regulators that are involved in muscle wasting.

Effect of Aging on Muscle-Pump Baroreflex of Individual Leg Muscles During Standing.

Activation of leg muscles is an important component in the regulation of blood pressure during standing, failure of which could result in syncope and falls. Our previous work demonstrated baroreflex mediated activation of leg muscles (muscle-pump baroreflex) as an important factor in the regulation of blood pressure during standing; however, the effect of aging on the muscle-pump baroreflex of individual leg muscles during standing remains to be understood. Here, the interaction between systolic blood pressure (SBP) and the activation of lateral gastrocnemius (LG), medial gastrocnemius (MG), tibialis anterior (TA), and soleus (SOL) muscles during standing was quantified. Beat-to-beat heart period (RR interval), SBP, electromyography impulse (EMGimp) were derived from continuously acquired electrocardiography, finger blood pressure, and calf-electromyography, respectively. The cardiac baroreflex (SBP→RR) causality (0.88 ± 0.08 vs. 0.94 ± 0.03, p = 0.01), percent time with significant coherence (%SC: 50.95 ± 23.31 vs. 76.75 ± 16.91, p = 0.001), and gain (4.39 ± 4.38 vs. 13.05 ± 8.11, p < 0.001) was lower in older (69 ± 4 years) compared to young (26 ± 2 years) persons. Muscle-pump baroreflex (SBP→EMGimp) causality of LG (0.81 ± 0.08 vs. 0.88 ± 0.05, p = 0.01) and SOL (0.79 ± 0.11 vs. 0.88 ± 0.04, p = 0.01) muscles was lower in older compared to young persons. %SC was lower for all muscles in the older group (LG, p < 0.001; MG, p = 0.01; TA, p = 0.01; and SOL, p < 0.001) compared to young. The study outcomes highlighted impairment in muscle-pump baroreflex with age in addition to cardiac baroreflex. The findings of the study can assist in the development of an effective system for monitoring orthostatic tolerance via cardiac and muscle-pump baroreflexes to mitigate syncope and falls.

Modulation of soleus stretch reflexes during walking in people with chronic incomplete spinal cord injury

In people with spasticity due to chronic incomplete spinal cord injury (SCI), it has been presumed that the abnormal stretch reflex activity impairs gait. However, locomotor stretch reflexes across all phases of walking have not been investigated in people with SCI. Thus, to understand modulation of stretch reflex excitability during spastic gait, we investigated soleus stretch reflexes across the entire gait cycle in nine neurologically normal participants and nine participants with spasticity due to chronic incomplete SCI (2.5–11 year post-injury). While the participant walked on the treadmill at his/her preferred speed, unexpected ankle dorsiflexion perturbations (6° at 250°/s) were imposed every 4–6 steps. The soleus H-reflex was also examined. In participants without SCI, spinal short-latency “M1”, spinal medium latency “M2”, and long-latency “M3” were clearly modulated throughout the step cycle; the responses were largest in the mid-stance and almost completely suppressed during the stance-swing transition and swing phases. In participants with SCI, M1 and M2 were abnormally large in the mid–late-swing phase, while M3 modulation was similar to that in participants without SCI. The H-reflex was also large in the mid–late-swing phase. Elicitation of H-reflex and stretch reflexes in the late swing often triggered clonus and affected the soleus activity in the following stance. In individuals without SCI, moderate positive correlation was found between H-reflex and stretch reflex sizes across the step cycle, whereas in participants with SCI, such correlation was weak to non-existing, suggesting that H-reflex investigation would not substitute for stretch reflex investigation in individuals after SCI.

Nonlinear approach to study the acute effects of static and dynamic stretching on local dynamic stability in lower extremity joint kinematics and muscular activity during pedalling

Researchers have reported contradictory results on the effect of static and dynamic stretching on subsequent performance. Due to the importance of performance through static and dynamic stretching, the aim of this study is to investigate the acute effects of static and dynamic stretching protocols on local dynamic stability in lower extremity joint kinematics and muscular activities during pedalling using a nonlinear dynamics approach. Using a randomised crossover trial design, fifteen active males participated voluntarily in this research (mass: 69.02 ± 10.52 kg, height: 174.00 ± 6.74 cm, and age: 21.20 ± 1.47 years) and completed a pedalling trial in situations of without stretching (WS), after static (SS), and dynamic stretching (DS) of lower extremity. The lower extremity joint angles in the sagittal plane and the electrical activity of soleus, gastrocnemius medialis, tibialis anterior, vastus medialis, biceps femoris, and rectus femoris muscles were collected during 30 pedalling cycles at 70 rates per minute. The results of the repeated measure ANOVA indicated that the knee and ankle angle largest LyE was significantly lower in DS compared to WS and SS. The largest LyE in muscle activity is also significantly lower for all the muscles after DS compared to WS and SS (P ≤ 0.05). Regarding the positive effects of DS on the joints and the muscle activity local dynamic stability, it is suggested to use DS than SS in the warm-up program before repetitive activities like pedalling.

Mechanics and energetics of post-stroke walking aided by a powered ankle exoskeleton with speed-adaptive myoelectric control

BackgroundAnkle exoskeletons offer a promising opportunity to offset mechanical deficits after stroke by applying the needed torque at the paretic ankle. Because joint torque is related to gait speed, it is important to consider the user’s gait speed when determining the magnitude of assistive joint torque. We developed and tested a novel exoskeleton controller for delivering propulsive assistance which modulates exoskeleton torque magnitude based on both soleus muscle activity and walking speed. The purpose of this research is to assess the impact of the resulting exoskeleton assistance on post-stroke walking performance across a range of walking speeds.MethodsSix participants with stroke walked with and without assistance applied to a powered ankle exoskeleton on the paretic limb. Walking speed started at 60% of their comfortable overground speed and was increased each minute (n00, n01, n02, etc.). We measured lower limb joint and limb powers, metabolic cost of transport, paretic and non-paretic limb propulsion, and trailing limb angle.ResultsExoskeleton assistance increased with walking speed, verifying the speed-adaptive nature of the controller. Both paretic ankle joint power and total limb power increased significantly with exoskeleton assistance at six walking speeds (n00, n01, n02, n03, n04, n05). Despite these joint- and limb-level benefits associated with exoskeleton assistance, no subject averaged metabolic benefits were evident when compared to the unassisted condition. Both paretic trailing limb angle and integrated anterior paretic ground reaction forces were reduced with assistance applied as compared to no assistance at four speeds (n00, n01, n02, n03).ConclusionsOur results suggest that despite appropriate scaling of ankle assistance by the exoskeleton controller, suboptimal limb posture limited the conversion of exoskeleton assistance into forward propulsion. Future studies could include biofeedback or verbal cues to guide users into limb configurations that encourage the conversion of mechanical power at the ankle to forward propulsion.Trial registrationN/A.

Activation-Dependent Changes in Soleus Length-Tension Behavior Augment Ankle Joint Quasi-Stiffness.

The triceps surae muscle-tendon units are important in governing walking performance, acting to regulate mechanical behavior of the ankle through interaction between active muscle and passive elastic structures. Ankle joint quasi-stiffness (the slope of the relation between ankle moment and ankle rotation, kA) is a useful aggregate measure of this mechanical behavior. However, the role of muscle activation and length-tension behavior in augmenting kA remains unclear. In this study, 10 subjects completed eccentric isokinetic contractions at rest and at 2 soleus activation levels (25% and 75% isometric voluntary contraction) prescribed using electromyographic biofeedback. Ultrasound imaging quantified activation-dependent modulation of soleus muscle length-tension behavior and its role in augmenting kA. The authors found that soleus muscle stiffness (kM) and kA exhibit nonlinear relations with muscle activation and both were more sensitive to the onset of activation than to subsequent increases in activation. Our findings also suggest that kA can be modulated via activation through changes in soleus muscle length-tension behavior. However, this modulation is more complex than previously appreciated-reflecting interaction between active muscle and passive elastic tissues. Our findings may have implications for understanding normal and pathological ankle joint function and the design of impedance-based prostheses.

Lower extremity work along with triceps surae structure and activation is altered with jumping after Achilles tendon repair.

Achilles tendon rupture leads to long term plantar flexor deficits. The purpose of this study was to describe changes in jumping biomechanics along with triceps surae structure and activation in individuals after Achilles repair. Eleven individuals 1-3 years following Achilles repair and 10 healthy controls were included. Kinetics and kinematics, analyzed using a constituent lower extremity work (CLEW) approach, and muscle activity using surface electromyography (EMG) were collected during a unilateral hopping task. Triceps surae myotendinous structure was assessed using ultrasound imaging. There were no differences in jump height, absolute limb work, or cost of transport between groups. During takeoff, the knee did more (p < 0.001) and ankle did less concentric work (p < 0.001), and lateral gastrocnemius rate of rise was higher (p = 0.02) on the ruptured side. During landing, the knee did more eccentric work (p = 0.033) and lateral gastrocnemius (p = 0.003) and soleus (p = 0.02) activation amplitude prior to landing was higher on the ruptured side. Individuals after Achilles tendon repair shift work toward the knee and alter muscle recruitment. Differences in lateral gastrocnemius activity may indicate that it is well-situated to generate power during takeoff and assist in landing with the soleus. The lack of change in muscle activity and decreased cross sectional area of the medial gastrocnemius may suggest that this muscle atrophies and does not accommodate to the hopping task. Clinical Significance: Proximal lower extremity strengthening along with emphasizing medial gastrocnemius and soleus activation during the recovery of patients with Achilles tendon repair may be rehabilitative targets for improved jumping performance. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.

Spinal reciprocal inhibition in the co-contraction of the lower leg depends on muscle activity ratio.

The spinal reciprocal inhibition during co-contraction remains unclear. Reports on the reciprocal Ia and D1 inhibitions in the co-contraction are lacking, and a point about the muscle activity amount during co-contraction is unclear. This study aimed to clarify the influence of changes in the ratio of soleus (Sol) and tibialis anterior (TA) muscle activities in co-contraction on reciprocal Ia and D1 inhibitions. Twenty healthy adults were subjected to four stimulatory conditions: a conditioning stimulus-test stimulation interval (CTI) of - 2, 2, or 20ms or a test stimulus without a conditioning stimulus (single). Co-contraction [change in (Sol)/(TA) activity] was examined at task A, 0%/0% maximal voluntary contraction (MVC); task B, 5%/5% MVC; task C, 15%/15% MVC; task D, 5%/15% MVC; and task E, 15%/5% MVC. At 2-ms CTI, the H-reflex amplitude value was significantly lower in tasks A, B, C, and D than in the single condition. Among the tasks, the H-reflex amplitude values were lower for A, B, C, and D than for E. At 20-ms CTI, the H-reflex amplitude was significantly lower in tasks A, B, C, D, and E. Among the tasks, the H-reflex amplitude was significantly lower from task A and B to task E. The change in the muscle activity ratio during co-contraction could modulate reciprocal Ia inhibition depending on the Sol/TA muscle activity ratio. D1 inhibition at rest did not differ significantly when the Sol/TA ratio was equal or when TA muscle activity was high. During co-contraction with high Sol muscle activity, D1 inhibition decreased from rest.